FINAL- GI

Question 1

Define dyspepsia.

Answer 1

Chronic or recurrent pain/discomfort in the upper abdomen—especially postprandial fullness, epigastric pain, or burning.

Question 2

What are common causes of dyspepsia?

Answer 2

PUD, GERD, biliary colic, medication-induced gastritis.

Question 3

Which medications can cause dyspepsia?

Answer 3

NSAIDs, salicylates, erythromycin, theophylline, corticosteroids.

Question 4

What is the first-line treatment for functional dyspepsia?

Answer 4

Empiric trial of PPI.

Question 5

What causes GERD?

Answer 5

Inappropriate LES relaxation, low LES pressure, delayed gastric emptying, decreased esophageal clearance.

Question 6

What is the gold standard for diagnosing GERD?

Answer 6

Upper endoscopy (EGD).

Question 7

What lifestyle changes help manage GERD?

Answer 7

Weight loss, HOB elevation, avoid late meals, reduce fat intake, stop smoking.

Question 8

Which medications are used to treat GERD?

Answer 8

Antacids, H2 blockers (e.g., ranitidine), PPIs (e.g., omeprazole), metoclopramide.

Question 9

What are the risks of long-term PPI use?

Answer 9

Atrophic gastritis, B12 deficiency, C. difficile, osteoporosis.

Question 10

What is Barrett’s esophagus?

Answer 10

Premalignant condition with columnar epithelium replacing squamous epithelium in distal esophagus.

Question 11

What is peptic ulcer disease (PUD)?

Answer 11

Ulceration of the gastric or duodenal mucosa, 5mm or larger, penetrating the muscularis mucosa.

Question 12

What are the most common causes of PUD?

Answer 12

H. pylori infection and NSAID use.

Question 13

What is the classic symptom pattern of duodenal ulcers?

Answer 13

Gnawing pain 2–5 hours after meals or at night, relieved by food or antacids.

Question 14

What is Zollinger-Ellison Syndrome?

Answer 14

A condition with excess gastrin production leading to high acid output and recurrent ulcers.

Question 15

What tests are used to detect H. pylori?

Answer 15

Urea breath test, stool antigen, biopsy via EGD, or serology.

Question 16

What is the gold standard diagnostic tool for ulcers?

Answer 16

Endoscopy (EGD), especially for gastric ulcers or alarm symptoms.

Question 17

Which medications are used for acid suppression?

Answer 17

H2 blockers (e.g., ranitidine), PPIs (e.g., omeprazole), and prostaglandins (e.g., misoprostol).

Question 18

How is H. pylori treated?

Answer 18

Triple or quadruple therapy with PPI, antibiotics (amoxicillin, metronidazole, clarithromycin, or tetracycline), and bismuth.

Question 19

How does pain from gastric ulcers differ from duodenal ulcers?

Answer 19

Pain worsens with food; may occur in LUQ.

Question 20

What are common causes of nausea and vomiting?

Answer 20

Gastroenteritis, gastritis, drugs (e.g., opioids, antibiotics), MI, increased ICP, pregnancy.

Question 21

Which antibiotics are commonly used for traveler’s diarrhea?

Answer 21

Ciprofloxacin or azithromycin.

Question 22

What are examples of stimulant vs bulk-forming laxatives?

Answer 22

Psyllium (Metamucil), methylcellulose= Bulk forming/ Senna, bisacodyl= Stimulant

Question 23

What is Irritable Bowel Syndrome (IBS)?

Answer 23

A functional GI disorder with abdominal pain and altered bowel habits without structural cause.

Question 24

What is a useful diet for IBS patients?

Answer 24

Low FODMAP diet.

Question 25

What is diverticulitis?

Answer 25

Inflammation of diverticula, causing LLQ pain, fever, leukocytosis.

Question 26

What are common symptoms of diverticulitis?

Answer 26

Fever, LLQ pain, nausea, vomiting, altered bowel habits.

Question 27

What is initial treatment for uncomplicated diverticulitis?

Answer 27

Oral antibiotics (e.g., ciprofloxacin + metronidazole) and clear liquid diet.

Question 28

What are risk factors for colorectal cancer?

Answer 28

Age >50, family history, polyps, IBD, high-fat/low-fiber diet, smoking.

Question 29

What is the gold standard for CRC screening?

Answer 29

Colonoscopy.

Question 30

At what age should CRC screening begin for average-risk adults?

Answer 30

At age 50 (or 45 per recent guidelines).

Question 31

Where does Crohn’s disease affect the GI tract?

Answer 31

Anywhere from mouth to anus; commonly terminal ileum.

Question 32

What are hallmark features of Crohn's disease?

Answer 32

Skip lesions, transmural inflammation, fistulas.

Question 33

What are hallmark features of ulcerative colitis?

Answer 33

Continuous colonic involvement starting at rectum, mucosal inflammation.

Question 34

What is the first-line treatment for mild UC?

Answer 34

5-ASA agents (mesalamine, sulfasalazine).

Question 35

What is used for moderate-severe IBD?

Answer 35

Corticosteroids, immunomodulators, or biologics.

Question 36

How is lactose intolerance diagnosed?

Answer 36

Hydrogen breath test or symptom improvement with lactose-free diet.

Question 37

What lab tests are used to screen for celiac?

Answer 37

tTG-IgA and total serum IgA.

Question 38

What is the gold standard for celiac diagnosis?

Answer 38

Small bowel biopsy via endoscopy.

Question 39

What is the treatment for non-severe C. diff?

Answer 39

PO Vancomycin or Fidaxomicin for 10–14 days.

Question 40

What is the treatment for fulminant C. diff?

Answer 40

High-dose PO vancomycin + IV metronidazole; rectal vancomycin if ileus.

Question 41

What is gastroenteritis?

Answer 41

Inflammation of the stomach and intestines causing nausea, vomiting, anorexia, and diarrhea.

Question 42

Which pathogens commonly cause bacterial gastroenteritis?

Answer 42

Salmonella, Shigella, E. coli (STEC), Campylobacter, Listeria.

Question 43

Which viruses commonly cause foodborne gastroenteritis?

Answer 43

Norovirus, Hepatitis A, Rotavirus.

Question 44

Which parasites can cause gastroenteritis?

Answer 44

Giardia, Cryptosporidium, Cyclospora, Toxoplasma gondii.

Question 45

What symptoms suggest small bowel infection?

Answer 45

Watery, high-volume diarrhea.

Question 46

What symptoms suggest large bowel infection?

Answer 46

Bloody diarrhea and lower abdominal cramping.

Question 47

Which pathogens cause illness within 6 hours of ingestion?

Answer 47

Staphylococcus aureus and Bacillus cereus.

Question 48

What are key physical exam findings in gastroenteritis?

Answer 48

Signs of dehydration, orthostasis, and hypoalbuminemia.

Question 49

What does the presence of WBCs and RBCs in stool suggest?

Answer 49

Colonic or inflammatory source.

Question 50

What are initial treatments for gastroenteritis?

Answer 50

Oral rehydration with Pedialyte or Gatorade; IV fluids if severe.